Healthcare Law & Policy Archive

U.S. Department of Health and Human Services Releases the Final Rule on “Meaningful Use” of Electronic Health Records

On July 13, 2010, the U.S. Department of Health and Human Services released the long-awaited final rule on what constitutes “meaningful use” of an electronic health records (EHR) under the Health Information Technology for Economic and Clinical Health (HITECH) Act. With the release of the final rule, healthcare providers now have a clearer picture of

Steps Your Practice Can Take to Prevent Downcoding on Medical Claims

Almost all modern medical practices have experienced downcoding of their medical claims by insurance companies.  In simplest terms, downcoding describes the situation where a practice submits a claim based on a certain CPT code, but the insurance company automatically “downcodes” the claim to a code that effectively lowers the amount paid out to the physician. 

CMS Announces PECOS Deadline to be Pushed Up to July 2010

On May 5, 2010, the Center for Medicare and Medicaid Services (CMS) published an Interim Final Rule in the Federal Register which pushed up the deadline for all Medicare-participating providers to be enrolled in Medicare through the Provider Enrollment, Chain and Ownership System (PECOS).  Under the new rule, all physicians who order or refer imaging,

Red Flags Rule Delayed

The Federal Trade Commission announced at the end of May that physicians will be granted another temporary reprieve from having to comply with the Red Flags Rule, delaying its implementation until December 21, 2010. There is considerable controversy over this rule, which requires all creditors to implement policies to protect consumers from identity fraud. In

Doc Fix Medicare Legislation Postponed

This past weekend, President Barack Obama pressed Congress to pass Medicare legislation which would avert a planned 21.3% pay cut for doctors who see Medicare patients. The proposed Medicare “doc fix” bill was passed by the House but has been stalled in the Senate. The pay cuts were initially slated for June 1, but the

Medicare Physician Fee Schedule Cuts Delayed Again

Congress Approves Extension of Delay in Cuts Through May 31, 2010 On Thursday, April 15, 2010, President Obama signed the “Continuing Extension Act of 2010” into law in an effort to avoid a Medicare meltdown for seniors and military families.  The law delays the 21% cut to the Medicare Physician Fee Schedule through May 31,

A Quick Guide to e-Prescribing: Collect Your 2% Medicare Bonus in 2010

Since the passage of MIPPA (Medicare Improvements for Patients and Providers Act of 2008), healthcare providers across the country have begun to integrate e-prescribing into their practices. Under the Act, providers who successfully e-prescribe are currently eligible to earn a 2% bonus on their Medicare collections.  Moreover, the e-prescribing incentives are structured in such a

Health Care Reform Law Amends Timeframe for Filing Medicare Claims

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law as part of ongoing health care reform.  This legislation provides amendments to the time period for filing Medicare Fee-For-Service (FFS) claims.  Pursuant to section 6404 of the Act, the maximum time period for submission of all Medicare FFS

Obama’s Health Care Reforms Bill Enacted

After a long, hard-fought battle, the health care reforms initiated by President Obama are now slated for enactment. On Tuesday, March 23rd 2010, President Obama signed the $940 billion Healthcare Overhaul Bill, an event which will be considered one of the major events, if not the major event, in his presidency. The HealthCare Overhaul Bill

E-Prescribing Developments and Considerations – Part V

Many providers have asked for information regarding the application process for participating in E-Prescribing. In fact, there is not a formal, onetime application. However, a provider (or practice, as the case may be) will not be entitled to a bonus unless he or she consistently represents – in the context of claim submission – that